A PROSPECTIVE COMPARATIVE STUDY TO EVALUATE CLINICAL OUTCOME WITH VARIOUS MODALITIES OF TREATMENT FOR LIVER ABSCESS. -

.. Objective - This study was carried out to compare different modalities of treatment in management of liver abscess in terms of conservative versus minimal invasive techniques such as percutaneous needle aspiration (PNA) and percutaneous catheter drainage (PCD). Material and method – All patients admitted in surgery department with liver abscess were included in this study and given different modalities of treatment according to size of liver abscess on ultrasound. Size between 2 to 5 cm were given combination of medicines, 5 – 10 cm treated with PNA, >10 cm size abscess treated with PCD and surgical management needed for ruptured liver abscess. Persistence of cavity or clinical symptoms considered as failure of treatment. RESULT – Total 35 patients included in this study and 12 responded to conservative treatment and 21 patients required PCA and PCD while only 2 patients required open surgical treatment. A combination of antibiotics coverage and percutaneous aspiration was effective in majority of cases. CONCLUSION – Minimal surgical interventions like PCD and PNA are better than conservative treatment for the management of liver abscesses of size >5 cm, in terms of duration to attain clinical relief and duration for which parenteral antibiotics are needed. Pyogenic liver abscess are less common than amoebic liver abscess. Right lobe of the liver is most commonly involved in both types of abscesses. Radio-imaging techniques like ultrasonography (US) and computerized tomography (CT) are the modalities of choice for investigation purposes. Treatment modalities of these abscesses, first emphasizes on medical treatment, but if it is unsuccessful then only the surgical intervention should be taken up. Laparotomy and Drainage or Laparoscopic Drainage remains the standard of care for ruptured liver abscess. - See more at: .